Open AccessComparative efficacy of different types of antihypertensive drugs in reversing left ventricular hypertrophy as determined with echocardiography in hypertensive patients: A network meta‐analysis of randomized controlled trials
Author(s) -
Chen JianShu,
Pei Ying,
Li Caie,
Li Yinning,
Wang Qiongying,
Yu Jing
Publication year - 2020
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.14047
Subject(s) - medicine , left ventricular hypertrophy , cardiology , meta analysis , cochrane library , randomized controlled trial , antihypertensive drug , inclusion and exclusion criteria , adverse effect , blood pressure , pathology , alternative medicine
Reversing left ventricular hypertrophy (LVH) can reduce the incidence of adverse cardiovascular events. However, there is no clear superiority–inferiority differentiation between angiotensin‐converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), beta‐blockers (BB), calcium channel blockers (CCB), and diuretics in reversing LVH in hypertensive patients. To provide further evidence for choosing the optimal antihypertensive drug for improving LVH, we performed a network meta‐analysis of randomized controlled trials (RCTs) based on the Cochrane library database, Embase, and Pubmed, and identified 49 studies involving 5402 patients that were eligible for inclusion. It was found that ARB could improve LVH in hypertensive patients more effectively than CCB (MD −4.07, 95%CI −8.03 to −0.24) and BB (MD −4.57, 95%CI −8.07 to −1.12). Matched comparison of renin‐angiotensin system inhibitors (RASi) showed that the effect of ACEI in reducing left ventricular mass index (LVMi) was not effective as that of ARB (MD −3.72, 95%CI −7.52 to −0.11). The surface under the cumulative ranking for each intervention indicated that the use of ARB was more effective among the different types of antihypertensive drugs (97%). This network meta‐analysis revealed that the use of ARB in antihypertensive therapy could achieve better efficacy in reversing LVH in hypertensive patients.